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Contact Information

JIM B LIEBLONG, OD
2800 W MAIN
RUSSELLVILLE, AR72801
 Phone: 479-968-2020
 Fax: 479-968-8803
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for JIM B LIEBLONG · (Male)

NPI Number 1750378691
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 10/05/2005
Last updated 05/11/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • AR License # 2265
  • AR Medicaid 103901722
  • AR Other 16617000041 QUALCHOICE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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